A randomized, prospective analysis of five sperm preparation techniques before intrauterine insemination of husband sperm.
OBJECTIVE
To evaluate pregnancy rates (PRs) in women undergoing artificial insemination with sperm alternately prepared by one of five techniques: sperm washing, Percoll gradient centrifugation, swim-up, swim-down, or refrigeration/heparin treatment.


METHODS
Each treatment group alternated in a different order through the five sperm preparations. Pregnancy rates were compared for each sperm preparation.


METHODS
Two infertility centers, one located in an academic institution and the other a regional hospital.


METHODS
Three hundred sixty-three women undergoing 898 artificial inseminations with husband semen with a progressive motile sperm count of >20 million sperm per mL were randomly placed in the five treatment groups.


METHODS
Pregnancy rates.


RESULTS
The overall ongoing PR per insemination was 9.7% (87/898), including 6.12% for natural cycles (n = 196), 12.8% for clomiphene citrate-stimulated cycles (n = 101), and 10.3% for gonadotropin-stimulated cycles (n = 601). The highest ongoing PRs for sperm preparations followed the swim-up technique (13.2%, 26/197) and the Percoll gradient centrifugation technique (12.7%, 26/204).


CONCLUSIONS
These data suggest that the swim-up and Percoll gradient preparations result in higher PRs than the wash, swim-down, and refrigeration/heparin techniques.
Carrell
D T
DT
Division of Urology, University of Utah School of Medicine, Salt Lake City 84132, USA. dCARRELL@MSSCC.MED.UTAH.EDU
Kuneck
P H
PH
Peterson
C M
CM
Hatasaka
H H
HH
Jones
K P
KP
Campbell
B F
BF
D002499:Centrifugation, Density Gradient; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D006062:Gonadotropins / Q000627:therapeutic use; D006493:Heparin / Q000494:pharmacology; D006801:Humans; D007317:Insemination, Artificial, Homologous / Q000379:methods*; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012034:Refrigeration; D013094:Spermatozoa / Q000187:drug effects / Q000502:physiology*
D006063:Chorionic Gonadotropin; D006062:Gonadotropins; D002996:Clomiphene; D006493:Heparin